Friday, March 16, 2012

Time to get the goblins out of our healthcare system

Just when you thought you could predict my blog topics, I am going to foil you and not do a post on the rice study in BMJ. I feel like after the last two days with the "meat kills" and "PSA screening saves lives but does not reduce mortality" posts you are not only fed up, but also competent enough to do your own debunking. Let me know if you need any help with that, by the way.

No, in honor of Friday, I will do a fluff post about a show that my family and I are hooked on. Yes, we are addicted to the BBC series "Merlin." Guess what it's about. The new twist is that it is set when both Merlin and Arthur are young men, and it is Merlin's job to keep Prince Arthur from succumbing to his enemies or to his own folly, so that he can lead Camelot forever and ever amen. It has everything you would expect: castles, bloody sword-fight scenes, dragons. Its heroes and villains are an epidemiologist's dream, since they are all evil or all good with nothing in between. It has magic, though that mostly stays in the closet, as Arthur's misguided father King Uther is quite magic-phobic.

Well, last night we witnessed a first in the Episode 3 of Season 3 -- a mischievous goblin got inadvertently released from his lead-lined wooden box and invaded the body of the court physician and Merlin's mentor and friend Gaius. As we all know, of course, goblins are hungry for gold (almost literally -- you'll have to watch the episode). Normally a caring and reasonable man, the pillar of his community, the elderly physician became a raucous and self-centered party animal in search of gold coins at all costs, so-to-speak. In one scene while making a house call to a sick peasant he indicated that the man would die without the potion that Gaius was holding in his hands. Yet he would not part with the potion unless the sick man and his wife produced a gold coin as payment. "But we are so poor," the family explained, " and you have never charged us before." Well, the new and improved market-driven Gaius could not be swayed, and the family ended up giving up their meager wealth to "cure" the husband, who incidentally was merely suffering from a broken rib.

In the next scene, in his continued search for gold coins, Gaius-come-goblin is accosted by Guinevere (in this version she is merely a servant to Lady Morgana -- long story), who is suffering from some ill-defined but clearly innocuous symptom. He takes this opportunity to sell her a potion without which he claims she will succumb to the deadly infection that is gripping Camelot. And despite her obvious skepticism, she is so driven by the fear of the "what if," that she hands over her coin for the tonic and peace of mind.

If all of this seems familiar, but you just can't put your finger on how, I'll give you a hint: our US healthcare "system." It's like there is a goblin in it, who in his relentless pursuit of gold is bankrupting the nation and disease-mongering to increase profit. Of course this allegory has no nuance, and why should it: this is after all a TV series about a magical medieval kingdom whose name itself has come to mean "utopia." Yet it is jarring to realize just how close to our reality this story is.

I am sure you are all anxious to find out how the episode ended. Did the peasant survive? Was Gaius able to regain his body? Did the goblin get back into his box? For answers to all these questions you can go to Netflix. As for our healthcare system, isn't it time we chased the goblins out?

Welcome and a disclaimer

Welcome to my blog, "Healthcare, etc."! In this blog I take the perspective of a researcher/policy wonk rather than an individual healthcare practitioner. Therefore, all opinions that I express and generalizations that I make about any issues will in no way be construed as medical advice for individual visitors / readers. All views expressed here are solely my own, and do not represent opinions of any organizations with which I am affiliated. I welcome all comments, but reserve the right not to publish paranoid or abusive rants or overt marketing pitches.

About Me

I am an independent physician health services researcher with a specific interest in healthcare-associated complications and a broad interest in the state of our healthcare system. I am also a professor of Epidemiology at the University of Massachusetts, Amherst.
I am frequently invited to speak about evidence-based medicine, methods and healthcare-associated complications.
My posts have been syndicated on The Health Care Blog, KevinMD,The Healthcare Collective and other sites. They have also been cited in the New York Times. Occasionally you can also find me blogging on the British Medical Journal blog site http://www.doc2doc.bmj.com
If you would like to contact me about my research, blog posts or speaking, please e-mail me at Healthcareetcblog@gmail.com